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Axial T2-Weighted Fast SE Best for Detecting Normal Appendix

November 2, 2009
Written by: , Filed in: Abdominal Imaging
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A recent study reported in Radiology was conducted to evaluate asymptomatic children and adolescents to determine the rate of detection of the normal appendix with unenhanced MRI.

The study concluded that MRI can be used to detect a normal appendix and exclude appendicitis. The greatest rate of normal appendix detection was found with the axial T2-weighted fast SE sequence (48%).

The Study
This study included 40 asymptomatic volunteers who underwent MRI to detect the appendix.

Methodology
The MRI protocol consisted of axial T1-weighted fast spin-echo (SE), axial and coronal T2-weighted fast SE, and axial T2-weighted fat-saturated fast SE sequences.

Two observers interpreted results independently, and coefficients were calculated to evaluate agreement.

The rate of detection was defined as the percentage of times that the appendix was visualized with at least 1 sequence.

Related CME:
NEW FOR 2009
Abdominal & Thoracic CT/MR/US: Optimizing Practice
The University of California, San Francisco School of Medicine
Evolving technology improves radiological practice through improved image quality for anatomical interpretation and generation of functional data. The use of MDCT and fast, multi-phase imaging sequences also translates to a tremendous increase in data that requires review and handling and greater need for contrast and radiation safety awareness. This activity targets the community radiologist involved in body and cardiovascular imaging with a focus on developing an efficient workflow practice in the modern imaging environment.
Read more or order: Abdominal & Thoracic CT/MR/US: Optimizing Practice

CT/MRI of the Abdomen and Pelvis
University of California San Francisco Department of Radiology and Biomedical Imaging
Provides an updated review on the use of helical (single and multidetector-row) CT and MRI for imaging of the abdomen and pelvis. Participants will learn the current approach and uses of CT/MRI in the examination of the abdomen and pelvis including advances in abdominal MRI techniques, genitourinary applications of CT/MRI, CT colonoscopy, CT/MR angiography, and CT cholangiography.
Earn up to 12 AMA PRA Category 1 Credits™.
Abdominal Imaging CME

Results
The normal appendix was detected by 1 observer in 19 cases (48%) and by the other in 20 cases (50%). The rate of appendix detection after observers reached a consensus was 48% (95% CI, 32% to 64%).

Interobserver agreement for appendix detection was good for most sequences analyzed.

The greatest rate of normal appendix detection was found with the axial T2-weighted fast SE sequence (48%).

Conclusions
The rate of normal appendix detection in children and adolescents with unenhanced MRI was 48%, which is similar to CT, but lower than ultrasonographic detection rates.

Reviewer’s Comments
In the current ALARA (as low as reasonably achievable) radiation climate, continued development of alternatives to CT scan for the diagnosis of appendicitis should be carefully watched.

Author: Benjamin M. Taragin, MD

Reference:
Baldisserotto M, Valduga SG, da Cunha CFJS. MR Imaging Evaluation of the Normal Appendix in Children and Adolescents Radiology. Radiology; 2008;249 (October): 278-284

Related CME:
NEW FOR 2009
Abdominal & Thoracic CT/MR/US: Optimizing Practice
The University of California, San Francisco School of Medicine
Evolving technology improves radiological practice through improved image quality for anatomical interpretation and generation of functional data. The use of MDCT and fast, multi-phase imaging sequences also translates to a tremendous increase in data that requires review and handling and greater need for contrast and radiation safety awareness. This activity targets the community radiologist involved in body and cardiovascular imaging with a focus on developing an efficient workflow practice in the modern imaging environment.
Read more or order: Abdominal & Thoracic CT/MR/US: Optimizing Practice

CT/MRI of the Abdomen and Pelvis
University of California San Francisco Department of Radiology and Biomedical Imaging
Provides an updated review on the use of helical (single and multidetector-row) CT and MRI for imaging of the abdomen and pelvis. Participants will learn the current approach and uses of CT/MRI in the examination of the abdomen and pelvis including advances in abdominal MRI techniques, genitourinary applications of CT/MRI, CT colonoscopy, CT/MR angiography, and CT cholangiography.
Earn up to 12 AMA PRA Category 1 Credits™.
Abdominal Imaging CME
.
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